Gwynne Dyer is a Canadian-born independent journalist whose column is published in more than 175 papers in 45 countries.

It was my wife Tina who noticed it first, a couple of weeks ago. Her father Charl, a clever, gentle man whom we all loved, was addicted to steroids – a doctor ‘friend’ started him off on whole-body doses for asthma about fifty years ago – and over time his face had puffed up a bit in the usual way. She said she could see the same changes in Vladimir Putin’s face.

Out of curiosity, we went back and looked at earlier pictures of Putin, and we thought we could see the same phenomenon. He’s obviously been a body-builder for much of his life, and many, perhaps most body-builders, take steroids at some point. And some long-term steroid users, including Tina’s father (although he wasn’t a body-builder), get hooked.

I wish I had paid more attention to Tina’s remark about Putin, but instead I went on predicting that Putin would not invade Ukraine until only a few days before he did, on the grounds that no rational leader, however ruthless, would do that. He might bluff about doing it, but actually doing it held nothing but downsides for Putin, and he wasn’t stupid.

And yet he invaded. Three days later I heard Lord David Owen, former UK secretary of state for foreign affairs but also an experienced medical doctor trained in neurology and psychology, telling Radio London that he had spotted the same puffiness as Tina in Putin’s face, and had reached the same conclusion. But he then went a bit farther.

“Look at his face, see how that has changed,” Owen said. “He now has an oval face. People said ‘Oh, it’s plastic surgery or Botox’, but I don’t believe that at all. He’s on either anabolic steroids as a bodybuilder – and he’s very proud of his muscles and strips to the waist and everything like that – or he’s on corticosteroids.

“If you’re on these drugs, they give you this face. They reduce your immunity and make you more vulnerable to Covid. This man has been in complete isolation, quite extraordinary, won’t see anybody, stays miles away, tremendous pressures. Which indicates he’s on a steroid and probably, maybe, a combination of both.”

As television diagnoses go, that’s pretty convincing. And it would explain a lot: not just the 15-metre tables with him at one end and his generals at the other, but maybe also the invasion of Ukraine. Anabolic steroids are associated with increased irritability and aggression; corticosteroids are sometimes linked to mania and psychosis.

I wouldn’t make policy solely on this diagnosis, but it needs to go into the mix when thinking about how to deal with Putin. A man who destroyed Grozny and helped raze east Aleppo could also erase Kyiv and its inhabitants while being quite sane, but the sanity of a man who hints at using nuclear weapons if anybody tries to thwart him is questionable.

One precedent that may be under consideration in Washington is the kind of declaration President John F. Kennedy made during the 1962 Cuban crisis, just changing the names to say that “any nuclear missile launched from Russia against any nation in Europe will be regarded as an attack by Russia on the United States, requiring a full retaliatory response upon Russia.”

It might not deter Putin, but it would certainly terrify the generals around him. On the other hand, it would also terrify the generals around Joe Biden. Hold off on this one for now.